Hemorrhoids are basically varicose veins surrounding the rectal area. The hormones of pregnancy cause a relaxation of all smooth muscle. The veins are smooth muscles. This relaxation in combination with the increased blood volume and pressure that occurs during pregnancy makes a pregnant woman more prone to hemorroids. Keeping the stool soft by have a diet high in fluids and fiber should help to prevent worsening of hemorroids. Wearing support panty hose can also help. Remember to put panty hose on before you stand up in the morning or lie down for 5 minutes with your feet higher than your head and then put on your pantyhose.

To decrease worsening at the time of delivery, I would recommend not pushing until the baby has descended spontaneously into the vagina. This means waiting until the urge to push is uncontrollable. When you begin to push I recommend using an open glottis pushing. This means you do not hold your breath and push but allow a small steady amount of air to be released continuously while pushing. Usually you will be able to hear the air being released while pushing. The push will not be silent but wll sound more like a prolonged "AHHHHHHHHHHH".

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